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Overall, since my diagnosis, I've been doing really well with HIV. Atripla has worked amazing for me, and I hardly even think about it. It's so easy to tolerate. My problem is not living with HIV, social life, or even meds. As I'm sure everyone who is poz knows, labs are a periodic reality of living with HIV. For me, my doctor usually orders labs done about every 5-6 months or so, or about twice a year, before I have my appointments with her, so she can monitor all my numbers and make sure I'm doing well. Here's my problem. I have a MAJOR fear of getting blood drawn. Like, severely. I'm not an anxious person either, so it sucks. What's odd is that I don'd mind getting shots in the least.

The problem is, whenever I have my blood drawn for labs, going back as long as I can remember, which has been about 3 years, I get really really nauseated, then clammy, then pass out. Initially, it wasn't anxiety-caused, and it didn't even happen every time..But as the incidents of me passing out when getting blood drawn increase, my anxiety and apprehension about having labs done increases. I am filled with dread after I put off having it done for as long as possible, and finally when I do go I'm a nervous wreck.

I am a healthy weight, I don't do drugs or anything bad, and I don't have any known medical problems. I make sure to eat a good meal before each lab. But it's like, after they stick me in my arm, after a few minutes, a physiological reaction happens, beyond my control, and I start getting clammy, sweaty, and pass out, and usually feel like I'm going to throw up..The last time I had labs, I even asked if I could have a private room and lay back on a table before they did it, so I'd be more prepared...And I STILL got sick and nearly passed out! Each time, within like 3-4 minutes though, I'm fine again. Is there ANY way to overcome this? Possibly get the blood drawn from a different part of the body than in the bend of my arm? Maybe having it done there is triggering some weird reaction? At any rate, I am lucky that I don't have any major problems, so this probably seems silly to some, but it really fills me with dread every time I have to have labs done. Any suggestions? Thanks!

It's called a vasovagal response. The vagus nerve sends a signal to open your blood vessels, blood pressure drops, and your brain is temporarily deprived of oxygen and you faint.

Has your phlebotomist or technician/medical assistant ever suggested you lie down when you have your blood drawn?

You and he/she can figure out what will work best for you. Having a cool cloth for your forehead would be nice. You've got four draws a year moving forward so getting a method worked out sooner will reduce your anxiety beforehand.

Thanks, I've heard of that term before. I suspect you may be right about it causing my problem. Because each time I do pass out when I have the blood drawn, it's involuntary, I can't control it, no matter how relaxed I think I am going into it..Last time, I had a private room, and had some juice before, but I don't think I laid down. None of the technicians have suggested I lay down before, but I will request it next time. I also will request a cold rag on the forehead, to see if that helps. I hope I can resolve this, it's just so irritating and embarrassing when it happens.

If they're not suggesting it, and they should be doing everything to prevent your fainting and possibly injuring yourself, then take the reins.

There are other little things you can do like increase your salt intake in advance, tense your muscles (like pilots do when pulling g's on steep ascent) but I think your most conservative and easy prevention is lying down.

I used to have troubles with this-- it is indeed vasovagal response. Here's how I deal with it:

1. Pick something pleasant to look at in the lab (leave needle out of view).. STARE2. Remember to breathe

Number two is easier said than done, I know.. good lab techs know how to work a patient.. I've had a few tell me to breathe.

While this is good advice -- it is not always going to work. AND -- whether you pass out or not is not about "the good lab tech knowing how to work a patient" (not sure what that means). They should tell you to breathe, it's true. The best advice I can give you -- and I worked as a lab tech for many years and drew thousands of patients over that time -- is to insist that you be drawn while laying down. It will make it easier on you and your phlebotomist if you do pass out -- a body becomes dead weight when you pass out and that tech has a needle in your arm and all your weight potentially coming at them.I know how tough this is for you, so it's important to just be up front about it before hand, so that the tech is looking out for it. Laying down may also stop the fainting.

I feel you on the fear of needles/giving blood. In fact, the first time I had labs (when they took 16 tubes) I almost passed 1/2 way through the draw. The tech thought they were going to have to do future labs with me lying down. Which is definitely not a bad idea to ask the tech to allow you to do - until you are able to perhaps put some things in place to help you overcome the sick/passing out reaction.

I have gotten over my fear of giving blood - getting labs done.... At least if it is under 12 tubes (they typically take between 5-8). What I have done.... 1) don't watch the needle at all.... I usually try to find a good vein before I go in and let the tech know which arm it is on.... I don't want them having to poke me more than once... I keep my head turned while they are doing the complete draw - from the time I stretch my arm out and they put the strap on all the way until I feel them putting the cotton ball and band aid on....

Sometimes during the draw - in addition to looking away, I either hum a song softly to myself, count numbers (let the OCD kick in) or make small talk with the tech..... sometimes I even talk to them about how I almost passed out when giving 16 tubes, but how I am so much better now with just a few tubes (I will sometimes even ask how many tubes they are doing that day - just depends on my mood).

The couple of times that I have had any type of precedure done that causes me the type of anxiety you have - which many procedures cause me the same feeling (i.e. syphillis shots - when I got them; lumbar puncture; having a boil lanced - three different times now; getting dental work done; and sometimes getting an IV - or even a flu or tetanus shot)..... I will stay in the room for a few minutes afterward - I agree w/ putting a cool towel on the head.... South Florida weather can really do a number with anxiety and leaving the clinic too quick (already feeling sick and like one is going to pass out, sweating in the A/C and then leaving to 90+ degree humidity outside). When I do stay after because of feeling "yucky" I usually will put my head in between my legs.... to try to get the blood flow back to my head ---

I also do my best during the procedure to try to remember to keep as normal of breathing as possible - but as anyone who has anxiety attacks knows or that suffers from lab needle anxiety/medical procedure fear knows, this is sometimes easier said and thought than done...

Always good to let the healthcare provider know that you get extreme anxiety and that it doesn't always occur just while the procedure is going on.... I have had docs/nurses/techs who thought I was okay because I made it through the procedure only to see me almost go down for the count 5 to 15 or 20 minutes later (good to let them know this also - so they understand if you either don't get up and leave real quick - or if they see you hanging around the waiting room for a bit afterwards).

I remember when I had my second round of syphillis shots done and left the building thinking I was okay - I walked in the heat to the parking garage and got on the elevator - when it hit... I had to kneel down in the elevator - one of the passengers kept asking me if I was okay.... and stayed with me until I was able to stand upright and make my way to my car - where I sat for another 20 minutes until I was sure that I was okay to drive.

Believe me when I tell you that you are not alone..... Take some of the suggestions on here, see what works, and put your own spin on them - I believe you will eventually find the one or combination or come up with a method that works best for you (and definitely don't put yourself at risk - best to lay down and inform the techs and take it easy afterwards)....

I didn't realize that so many others have this same issue. I too have a dreaded fear and I bent the needles from tensing up back at my first draw.

Explain to the tech your anxiety. I'm fortunate that I have the same one most of the time. She has to constantly remind me to breath. I also find it helpful to have a magazine and an article ready to read.

It has gotten easier through the years so hopefully it'll lessen for you too.

Thanks for all the great responses everyone. I will definately be more proactive about this from now on, believe that! The fainting that happens to me when giving blood is beyond my control. It's totally involuntary. It doesn't matter how good the particular technician/phlebotomist is...Next time, I will make sure and ask to have a private room, lay back first, have a cold rag, and they also told me I could cough to alleviate the vagus reaction...It's just so embarrassing, and makes me feel stupid. I'll tell you one thing, I'll make sure I tell them up front that I want every possible effort made to prevent me from passing out so I don't fall and hurt myself. In the past, I didn't take the initiative, but now that I know I'm prone to this when giving blood, I will be MUCH more insistent and proactive.

But, isn't there ANY other place on the body that they could draw the blood from, other than the bend of the arm? Maybe a spot that would be less likely to trigger a vagus reaction/fainting? Or would it happen regardless if I'm prone to it? Last time I had blood drawn, I ate before, and laid back, but I STILL got sick and passed out. Ugh.

But, isn't there ANY other place on the body that they could draw the blood from, other than the bend of the arm? Maybe a spot that would be less likely to trigger a vagus reaction/fainting? Or would it happen regardless if I'm prone to it?

Nope! I have a port implanted for chemotherapy, and I have had a vagus reaction from it being accessed as well. I think it's a natural aversion to needles

"Hey, this is part of the involuntary you -- no embarrassment, nothing to feel stupid about. I love your change in attitude and I would add to your plan for next visit that you say -- "Would you please make it a part of my record that I have a vasovagal response and I've been advised by several medical professionals to lie down before the draw and place a cool cloth on my forehead." And take your time before you rise to your feet with someone observing you.

I write this because I sense you foresee there might not be buy-in on the techs' parts. This way, you've made a specific request to make it part of your records and not to be ignored. If your ID doc doesn't know this about you (and they may well not know unless you share it!) get him or her in on it in advance and ask the same thing. That way you can say to the tech, " I spoke with Dr. So and So and it's now been made a part of my medical records that I.....blah, blah, blah" Then, you'll get the respect and care you require.

As to other sites for a draw, hand or forearm are alternates, but the elbow has fewer nerves to deal with and a vein close to the surface. If you've never had a needle in your hand, and I have, I'd advise against it. It's used for certain reasons at certain times, but not a solution in your situation. Frankly, it's freaky and I always find I'm concerned it will be yanked out without the semi-cradle of the elbow area and forearm. I'm a needle watcher from start to finish, but that technique makes me feel on-guard and not relaxed.

So, you know we all want to know WHEN are your next labs likely or scheduled? Cuz we're gonna wanna know how it goes for you and cheer you on!!!

While this is good advice -- it is not always going to work. AND -- whether you pass out or not is not about "the good lab tech knowing how to work a patient" (not sure what that means). They should tell you to breathe, it's true.

Mike-- work the patient.. ie watch for signs and react accordingly. Good nurses know diversion tactics, and know when to ask you to lie down. That, along with technical skill can reduce fainting from blood draws.

I'm talking about the human aspect of invading someone's body with a needle to draw fluid-- say hi, make them comfortable and talk about things to help the patient's mind wander away from the situation. That's working the patient. Of course the things that help me won't help everyone else, but they're worth a try.

Cognitive Behavioral Therapy is used to treat anxiety issues of all sort -- why would this not be an option here? I'm thinking for a long-term solution, the shot term one about lying down on a table, etc. Just a thought.

I have the same issues. There have been times where I have become faint and it only took twice until I ask if I can lay down. I have tattoos and can sit through a 3-4 hour session no problem, but the thought of getting blood drawn makes me faint. Usually I bring a piece of fruit or orange juice to keep in the car for afterwards too.